青少年L_(4/5)和L_5/S_1椎间盘突出症的相关形态学和解剖学参数的影像学研究

Research of morphological and anatomical parameters in adolescents with lumbar disc herniation by imageology

目的观察青少年腰椎间盘突出症(ALDH)患者脊柱骨盆形态学参数和解剖学参数,探讨L_(4/5)和L_5/S_1椎间盘突出的差异性。方法选取2010年1月~2015年6月百色市人民医院确诊的57例ALDH患者分为L_(4/5)ALDH组(31例)和L_5/S1ALDH组(26例),同时选取年龄匹配的健康志愿者作为对照组(36例)。测量形态学参数:骨盆入射角(PI)、骨盆倾斜角(PT)、骶骨倾斜角(SS)、腰椎前凸角(L_L_)、和L_1椎体中心至骶骨间垂线距(LASD)。测量解剖学参数:髂骨高度(ICH)、L_4椎体横突长度(TPL_)、L_5TPL_、L_4横突宽度(TPW)和L_5TPW。结果 L_(4/5)ALDH组和L_5/S_1ALDH组患者SS和LL均显著低于对照组(P<0.05),而PT和LASD显著高于对照组(P<0.05),PI差异无统计学意义(P>0.05)。L_(4/5)ALDH组和L_5/S1ALDH组的L_4TPW和L_5TPW均显著小于对照组(均P<0.05),ICH差异有统计学意义(P<0.05),L_4TPL_和L_5TPL_差异无统计学意义(P>0.05)。结论 ALDH患者PI值与正常青少年相近,但患者表现出明显的骶骨垂直化及腰椎生理曲度减小;而ALDH发生的节段与ICH有关,L_(4/5)椎间盘突出患者髂骨相对较高而L_5/S1椎间盘突出患者髂骨较低。

Objective To observe the morphological and anatomical parameters of spinopelvic of patients with adolescent lumbar disc herniation （ALDH）, in order to assess the otherness of L4/5 ALDH and L5/S1 ALDH. Methods From January 2010 to June 2015, 57 patients with ALDH diagnosed in the People＇s Hospital of Baise were divided into Lws ALDH group （31 cases） and L5/S1 ALDH group （26 cases）. At the same time, the age-matched healthy volunteers were selected as control group （36 cases）. Morphological parameters were measured, including pelvic incidence （PI）, pelvic tilt （PT）, sacral slope （SS）, lumbar lordosis （LI,） and L1 axis St distance （LASD）. Anatomical parameters were measured, including iliac crest height （ICH）, L4 transverse process length （TPL）, L5 TPL, L4 transverse process width （TPW） and L5 TPW. Results The measuring results of LL and SS in Lzs ALDH group and Ls/Sl ALDH group were significantly lower than control group （P 〈 0.05）, the measuring results of PT and LASD were significantly higher than control group （P 〈 0.05）, and the measuring result of PI had no significant difference （P 〉 0.05）. The measuring results of L4 TPW and Ls TPW in L^s ALDH group and LdS~ ALDH group were significantly lower than control group （P 〈 0.05）, the measuring result of ICH had significantly difference （P 〈 0.05）, and the measuring results of L4 TPL and L5 TPL had no significantly differences （P 〉 0.05）. Conclusion PI value of patients with ALHD is closed to normal adolescents, but the patients are characterized by obviously vertical sacrmn and straight lumbar spine; the spinal segment of dics herniation is associated with ICH, the patient with L4/5 ALDH has a relative higher ICH, while the patient with L5/S1 ALDH has a lower ICH.